Z6 · Risk of injury from numbness
Risk Brain and senses
Definition
Loss of feeling raises the chance of unnoticed injury.- Diabetes
- nerve damage
- spinal injury
- pressure
- Cannot feel touch or pain
- injuries unnoticed
- tingling
📋 Scenario
A diabetic with reduced feeling in both feet walks barefoot at home.
Subjective (S): "I cannot feel my feet very well."
Objective (O): Reduced feeling to light touch in both feet; diabetic; walks barefoot; skin intact; no injuries seen.
Assessment tools for this scenario: CP-NEURO Brain & Senses Check CP-SKIN Skin & Wound Score
Validated scales to consider: GCS, pupils, NIHSS, Braden Scale, TIME wound chart
**CarePath diagnosis:** Risk of injury from numbness related to diabetes and nerve damage (risk factors); no signs of the problem are present yet.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Check both feet daily for cuts, blisters and color change. | With reduced feeling she will not notice small injuries. Daily checks of both feet find cuts, blisters and color change early, before they become infected ulcers. |
| Protect from heat and cold; test bath water with the elbow. | Numb skin cannot sense dangerous temperatures, so burns and frostbite can happen without pain. The elbow is more sensitive and gives a better warning than the feet. |
| Teach to wear shoes and socks at all times and check shoes before wearing. | Shoes and socks protect numb feet from sharp objects, hot ground and friction. Checking inside shoes finds stones or rough seams she could not feel. |
| Refer to a foot specialist (podiatry). | A podiatrist can assess nerve and circulation changes, trim nails and calluses safely, and advise on footwear, which lowers the chance of a hidden foot problem. |
| Report any new sore, blister or color change the same day. | In diabetes, small foot wounds can worsen quickly because of poor healing and infection risk. Same-day reporting allows early treatment and helps prevent ulcers and serious complications. |
**Expected outcomes**
- No new foot injury during the follow-up period.
- Patient states and demonstrates a daily foot-check routine.
- Patient wears shoes and socks outdoors and indoors.
**Linking the data to the diagnosis**
This is a risk diagnosis because no injury has happened yet. The patient is diabetic, says, "I cannot feel my feet very well," and has reduced feeling to light touch in both feet. She also walks barefoot at home. Her skin is intact and no injuries were seen, so an actual injury statement would be wrong; the risk factors are the numbness and the barefoot habit. Protecting the feet matters because she cannot feel damage as it happens. The plan aims for no new foot injury, a daily foot check she can state and demonstrate, and shoes and socks worn both outdoors and indoors.
CarePath diagnosis
Risk of injury from numbness related to diabetes and nerve damage (risk factors); no signs of the problem are present yet.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Check both feet daily for cuts, blisters and color change. | With reduced feeling she will not notice small injuries. Daily checks of both feet find cuts, blisters and color change early, before they become infected ulcers. |
| 2. Protect from heat and cold; test bath water with the elbow. | Numb skin cannot sense dangerous temperatures, so burns and frostbite can happen without pain. The elbow is more sensitive and gives a better warning than the feet. |
| 3. Teach to wear shoes and socks at all times and check shoes before wearing. | Shoes and socks protect numb feet from sharp objects, hot ground and friction. Checking inside shoes finds stones or rough seams she could not feel. |
| 4. Refer to a foot specialist (podiatry). | A podiatrist can assess nerve and circulation changes, trim nails and calluses safely, and advise on footwear, which lowers the chance of a hidden foot problem. |
| 5. Report any new sore, blister or color change the same day. | In diabetes, small foot wounds can worsen quickly because of poor healing and infection risk. Same-day reporting allows early treatment and helps prevent ulcers and serious complications. |
Expected outcomes
- No new foot injury during the follow-up period.
- Patient states and demonstrates a daily foot-check routine.
- Patient wears shoes and socks outdoors and indoors.
Linking the data to the diagnosis
This is a risk diagnosis because no injury has happened yet. The patient is diabetic, says, "I cannot feel my feet very well," and has reduced feeling to light touch in both feet. She also walks barefoot at home. Her skin is intact and no injuries were seen, so an actual injury statement would be wrong; the risk factors are the numbness and the barefoot habit. Protecting the feet matters because she cannot feel damage as it happens. The plan aims for no new foot injury, a daily foot check she can state and demonstrate, and shoes and socks worn both outdoors and indoors.